The two sides played out a 1-1 draw in Belgium last week, with the home side unfortunate not to be travelling to the London Stadium this week holding an advantage.
Match preview
While West Ham would have been happy with their Europa Conference League draw, David Moyes would have also been wary about a Gent side that were very much in form.
That proved to be correct with West Ham having to withstand fierce pressure from the Belgian side to hold onto a share of the spoils ahead of the return fixture in London.
The tie is now on a knife edge, yet West Ham should take all of the positives from the draw with their current run of results now seeing just one defeat in eight outings.
Securing a comeback 2-2 draw with Premier League leaders Arsenal on Sunday has further eased the pressure on Moyes, whose team now sit four points clear of the relegation zone.
With extra breathing space in their favour, West Ham can now focus on trying to go deeper in this competition having put together an 11-match undefeated streak on the continental scene.
From Gent's perspective, they have won just four times since the beginning of the group stages, losing three times and needing penalties to see off Qarabag FK in the last 32.
Nevertheless, there is a feeling that Hein Vanhaezebrouck's side are the dark horses to lift the trophy having thrashed Istanbul Basaksehir in the last 16 and showcased their qualities in the first leg versus the Hammers.
Successive draws in the Jupiler Pro League versus Union SG and Mechelen have slowed their momentum, but they remain in the final Championship playoff spot.
Victory is required over 17th-placed KV Oostende to secure fourth spot, yet their full focus will be on this competition as they bid to move closer to the most notable achievement in their history.
West Ham United Europa Conference League form:
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D
West Ham United form (all competitions):
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D
Gent Europa Conference League form:
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L
W
D
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Gent form (all competitions):
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D
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D
Team News
With Angelo Ogbonna serving a one-match ban, Kurt Zouma should return to the West Ham defence, and Moyes will give consideration to further changes from the first leg.
Depending on whether Moyes goes with a central midfield two or three, Lucas Paqueta may return to take the spot of Ben Johnson.
Said Benrahma could also get the nod in the final third, while goalkeeper Alphonse Areola will return between the sticks.
Having made numerous changes at the weekend, Genk boss Vanhaezebrouck is expect to select a team similar to that from the first leg.
Although Matisse Samoise got on the scoresheet from right wing-back versus KV Mechelen, Alessio Castro-Montes should return there on Thursday with Malick Fofana taking his spot on the opposite flank.
West Ham United possible starting lineup:
Areola; Coufal, Zouma, Aguerd, Palmieri; Rice, Downes, Paqueta; Benrahma, Ings, Bowen
Gent possible starting lineup:
Roef; Torunarigha, Okumu, Piatkowski; Castro-Montes, Kums, De Sart, Fofana; Hong; Cuypers, Orban
We say: West Ham United 2-1 Gent (West Ham to win 3-2 on aggregate)
For all of the criticism of West Ham of late, they have a better recent record than they are given credit for. The Hammers are also unbeaten in this competition, and we are expecting them to battle their way to a notable victory on Thursday night.